Abstract
Purpose :
To assess the impact of continuous positive airway pressure (CPAP) on nocturnal intraocular pressure (IOP) in patients with treated primary open-angle glaucoma (POAG) and in people with healthy eyes.
Methods :
All recruited participants were newly diagnosed with obstructive sleep apnoea (OSA) and had indications for CPAP treatment. Nocturnal IOP measurements were performed in a supine position every 2 hours using a rebound tonometer. The measurements were obtained prior to starting CPAP and were repeated 4-6 weeks into the treatment. Data was analysed using a mixed design ANOVA.
Results :
14 POAG and 12 control participants were included. IOP in subjects using CPAP was significantly higher than at baseline with a mean increase of 2.7±2.2 mmHg (p=0.00) (Fig 1). There was no difference in IOP elevation between the groups (p=0.3). In 50% of participants IOP increased by ≥5mmHg at one or more time points. Ocular perfusion pressure, which was calculated based on blood pressure and IOP, decreased significantly during CPAP therapy (p=0.004).
Conclusions :
Our study confirms that CPAP raises nocturnal IOP. These findings may be particularly relevant to the management of people with POAG and coexisting OSA. Future studies should assess the long-term implications of using CPAP on glaucoma progression. At present, we would recommend that sleep specialists inform patients with known glaucoma, and their ophthalmologists, of the potential risk of CPAP related IOP increase at night.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.